Provider Demographics
NPI:1457983637
Name:RIVER CITY DOCS LLC
Entity Type:Organization
Organization Name:RIVER CITY DOCS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FROSTY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-894-2294
Mailing Address - Street 1:8105 DANFORTH CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-4931
Mailing Address - Country:US
Mailing Address - Phone:512-422-3571
Mailing Address - Fax:512-894-2295
Practice Address - Street 1:3944 RANCH ROAD 620 S STE 302
Practice Address - Street 2:
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-7000
Practice Address - Country:US
Practice Address - Phone:512-894-2294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty